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Dorjan Marušič, Petruša Miholič and Andrej Marušič

Vzdržnost in dolgoživost mreže psihiatrične dejavnosti v Sloveniji: predlog storitev na primeru otroške psihiatrije

Ravnovesje med ceno in učinkovitostjo dela je najbolje optimizirati s primerno mešanico strokovnih profilov in izkušenj. V članku sta predstavljeni matematični enačbi za izračun potreb za različne duševne motnje ter potreb po osebju za ustrezno obravnavo določene duševne motnje. Teoretično bi lahko vse oblike zdravljenja opravil pedopsihiater, kar pa bi, zaradi dražjega izobraževanja in plačevanja zdravnikov, po nepotrebnem dvignilo ceno storitvam. Ena od rešitev bi bil kompromis, kjer bi pomemeben delež otrok, ki ne potrebujejo terapije z zdravili, spremljalo nezdravniško osebje. Zagotovo pa bi bilo potrebno razdeliti delo v tri kategorije: na primere, ko naj pedopsihiatrija prevzame vodilno vlogo, primere, ko naj preostale ustanove prevzamejo vodilno vlogo ter primere, pri katerih naj bo pristop od vsega začetka večslojen. S krepitvijo interesa staršev in ostalih svojcev ter s spodbujanjem k organiziranju skupin za samopomoč, bo tudi pedopsihiatrija dolgoročno pridobila. Predstavljeni podatki in razmišljanja v članku naj bodo izziv za razpravo med vsemi udeleženimi pri morebitnem prilagajanju ali celo preoblikovanju pedopsihiatričnih storitev v Sloveniji.

Open access

Terry Jeremy Ellapen, Sumaya Abrahams, Farzanah A. Desai, Senthil Narsigan and Hendrick Johan Van Heerden

; 37: 29 14. Yard EE, Comstok RD. Injuries sustained by Pediatric Ice hockey, lacrosse, Þ eld hockey athletes presenting to the United States Emergency Departments 1990-2003.Journal of Athletic Training, 2006; 41(4): 441-449 15. Fong DT, Hong Y, Chan L, Yung PS, Chan K. A Systematic Review on Ankle Injury and Ankle Sprain.Sports Medicine; 2007; 37(1): 73-94 16. Marieb E. Human Anatomy and Physiology (7th edition). Benjamin-Cummings Publishing Company; 2004 17. Brukner P. Khan K. Clinical Sports Medicine

Open access

Davorina Petek, Nataša Kern, Milena Kovač-Blaž and Janko Kersnik

healthy eating behaviours in overweight adults. Prev Med 2005; 40: 769-78. Marrero DG. Changing patient behaviour. Endocr Pract 2006; 12 (Suppl 1): S118-S120. Svetkey LP, Stevens VJ, Brantley PJ, Appel LJ, Hollis JF, Loria CM et al. Comparison of strategies for sustaining weight loss: the weight loss maintenance randomized controlled trial. JAMA 2008; 299: 1139-48.

Open access

Terry Jeremy Ellapen, Carl Stow, Natalie Macrae, Jessica Milne and Hendrick Johan Van Heerden

Abstract

: Introduction: Water polo is an aggressive, competitive aquatic game played by two teams of seven players with the intention to defeat the opposing team by scoring more goals which occasionally generate musculoskeletal pain and injury. Water polo incorporates swimming, treading, throwing the ball, in a volatile, dynamic aquatic domain which lends itself to a high degree of aggression and direct physical contact among opposing players.

Aim: This study documented the prevalence of water polo related musculoskeletal pain among competitive adolescent male water polo players residing in Kwa-Zulu Natal, South Africa (n=100).

Material and methods: Subjects completed a self-report musculoskeletal pain questionnaire, which gathered their demographical, epidemiological and exercise history over the last 12 months. The following descriptive statistics (mode, mean, frequency, percentages) and inferential statistics (chi-square set at a probability of 0.05) were employed to analyse the data.

Results: Seventy-two of the cohort sustained musculoskeletal pain within the last 12 months (p< 0.001). The most prevalent anatomical sites that sustained water polo related musculoskeletal pain were; shoulder (51.04%), knees (23.95%) and vertebral column (17.71%) (p<0.0001). The predisposing mechanisms of producing this water polo related musculoskeletal pain were over-training (88.00%), rapid rotational movements (8.00%), collision with players (2.66%), and being struck with the ball (1.33%) (p<0.001).

Conclusions: Competitive adolescent male water polo players residing in Kwa-Zulu Natal, South Africa experienced a high prevalence of water polo related shoulder, knee and vertebrae musculoskeletal pain.

Open access

Saška Roškar, Alenka Tančič Grum, Vita Poštuvan, Anja Podlesek and Diego De Leo

Abstract

Introduction

The existing literature provides evidence of the link between media reporting and suicide in terms of either preventive or provocative effects. Hence, working with media representatives on responsible reporting on suicide is of great importance. Until recently in Slovenia, there has been an obvious lack of communication between media representatives and suicidologists. The aims of the present study were twofold; firstly, to introduce the adaptation and dissemination of intervention on responsible media reporting, and secondly, to evaluate the effectiveness of the implemented intervention on suicide reporting.

Methods

We used a pre-post research design. Newspaper articles were retrieved over two 12-month periods: the baseline period and the follow-up period. In between, we had a year of implementation of our intervention program (launching and disseminating the Guidelines via workshops). Each retrieved article was rated qualitatively with respect to its adherence to the Guidelines.

Results

The comparison of baseline and follow-up periods revealed some significant differences. Reporting in the follow-up period was less sensationalistic, there was less reporting about specific cases of suicides and more about causes of suicide and pathways out of mental distress. Furthermore, in the follow-up period, there was a significant improvement related to headlines of media articles. Contact information about where to seek help was more often included in the articles.

Conclusion

The findings are promising, but working with the media needs to be continuous and ongoing if sustainable results are to be achieved.

Open access

Tit Albreht and Niek Klazinga

Balancing equity and efficiency through health care policies in Slovenia during the period 1990-2008

Background: Slovenia's 1992 health reform set the following five goals: introduction of social health insurance system and a system of co-payment for a range of health care services; introduction of private practice in health care; devolution of planning and control functions from the State to professional associations and municipalities, and introduction of licensing and recertification for health professionals.

Methods: A descriptive and explorative analysis was done of general demographic, economic and health financing data and the reported data on financing structure. The general population health indicators for the observed period are presented. A broad health policy context was assessed through participatory observation during the whole period and using semi-structured interviews with key national health policy-makers in 2001, which served as a mid-term review.

Results: Transformation of health care system in Slovenia led to sustainable health care financing at a level of approx. 8.5% of GDP. This result was achieved at the expense of reduced public funding, which was partially compensated for by the supplementary health insurance and partially by an increase in out-of-pocket expenditures. Private expenditures increased the system's regressivity, which was corrected through risk-equalising schemes and by subsidising supplementary health insurance to the least well off.

Conclusions: Slovenia's health care transition took place during a period of economic growth, which afforded stable financing of the system and restricted the capacity of health care providers. This environment had a favourable impact on the general health situation of the population, and thereby reduced pressures on the new system. The previous system was transformed into a mixed social health insurance based system, based on a strong central insurer. The present financing scheme is unlikely to remain sustainable because of demographic trends and other drivers increasing unmet health care needs.

Open access

Andrzej Magiera, Artur Jagodziński, Katarzyna Kaczmarczyk and Ida Wiszomirska

Abstract

Introduction: Despite of sustainable living and increasing the knowledge of the future mothers, the number of preterm births have been at the same level through last years. In Poland it is stands at around 7%, comparable with other countries from European Union. The aim was to investigate the influence of prematurity on input power and regulation power during stress test in adult women. Achieved power depends on the level of physical efficiency and it is converted for specific VO2max values.

Material and methods: 11 women born prematurely at age of 25-30 years (28,2± 2,3) did stress test according to W150 protocol. The control group consisted of 15 women born on time (27-32, 28,5±2,4). The statistical analysis included t-Student and Shapiro-Wilk tests. Index height/regulation power and BMI/ regulation power have been subjected to correlations.

Results: There is statistical significant difference between input and regulation power in women born prematurely and the control group. Women from control group had significantly higher input and regulation power than women born premature. Moreover, there is proportionality between input and regulation power in two groups.

Conclusions:

1. Prematurity influences the amount of power generated in women aged 25-30 negatively - women born prematurely are evidently less physically efficient than women born on time.

2. There is a connection between input and regulation power in both groups. Higher amounts of input power indicates higher amounts of regulation power.

3. There is no relationship between BMI and amounts of power in stress test.

Open access

Przewłocki Sławomir and Ronikier Aleksander

Abstract

Introduction: Terminal patients require proper care standards and professional team of doctors, physiotherapists, social workers, educators, psychologists and clergy directly involved in mitigating the suffering of a dying person. A physiotherapist as a member of such a team should be focused on sustaining the patient’s quality of life until the end at the level relevant to the patient’s health state. This quality of life should be perceived integrally as a combination of procedures reducing pain and physical suffering as well as improving physical fitness and mental well-being.

Material and methods:The aim of the research was to define the role of physiotherapy in assessing mental and physical state of terminal patients; to determine the applicability of ADLs, GDS and BDI in diagnosing the validity and usefulness of tiresome physiotherapeutic procedures for terminal patients and to assess the applied tests in predicting terminal patients’ survival time. The research was carried out on the turn of 2012 and 2013 in the group of 103 subjects (74 females - 71.8% and 29 males - 28.2%) For the research the following methods were used:

- Activity of Daily Living scale (ADL)-

- Beck Depression Inventory (BDI)

- Geriatric Depression Scale (GDS)

- Questionnaire regarding their willingness to participate in physiotherapeutic procedures.

Results: In the research the range of diagnostic possibilities of the applied scales and tests, correlations between theses scales and tests as well as correlations between them and subjects’ age and survival time were assessed. Additionally, a questionnaire survey was carried out which assessed the willingness to participate in physiotherapeutic procedures. Strong stress, terminal state of the patient and generalisation of symptoms brought about the fact that only 14.6% of patients declared their willingness to participate in physiotherapeutic procedures.

Conclusions:

1. Implementing physiotherapeutic and psychological diagnostic tests in everyday terminal care makes it easier to assess survival time of terminal patients and significantly improves their life and dying with dignity

2. Proper understanding of the symptoms of dying must serve as a basis for organising adequate activities compliant with the progress of a disease of a terminal patient without disturbing the process of dying.

3. Modern physiotherapy in terminal care should limit the range of physiotherapeutic procedures and physical therapy while increasing psychological care in this population.

Open access

Helena Koprivnikar and Aleš Korošec

Abstract

Background. Smoking is initiated mostly by adolescents and young adults. In Slovenia, we have limited data about this. The purpose of this paper is to show data on age at smoking initiation and differences in age at smoking initiation by gender, age groups, education, social class and geographical region among inhabitants of Slovenia.

Methods. We used data from the cross-sectional survey ‘Health-related behaviour 2012’ in Slovenian population aged from 25 to 74 years.

Results. 4591 ever smokers, aged 25-74, that gave information about the age at smoking initiation were included in the analysis. At the age of 25 or less, smoking was initiated by 96.7% of Slovene ever smokers, at the age of 18 or less by 71.0%. The average age at smoking initiation was 17.7 years. Male ever smokers initiated smoking at an earlier age compared to female ones. Age at smoking initiation was decreasing in both male and female ever smokers, but was more pronounced in females. In male ever smokers, there were no differences in average smoking initiation age by education, self-reported social class and geographical regions, while in female ever smokers, there were significant differences in terms of education and geographical regions.

Conclusion. The initiation of smoking predominantly occurs in adolescents and young adults. Age at smoking initiation has decreased in recent decades. Our study confirms the importance of early and sustained smoking prevention programmes in youth and the importance of national comprehensive tobacco control programme with effective tobacco control measures to ban tobacco products marketing.

Open access

Biserka Simčič, Jakob Ceglar and Dorjan Marušič

ministrov državam članicam o ravnanju z varnostjo pacientov in preprečevanju neželenih dogodkov v zdravstvu. Stališče Sveta v prvi obravnavi z namenom sprejetja Direktive evropskega parlamenta in sveta o uveljavljanju pravic pacientov pri čezmejnem zdravstvenem varstvu: Svet EU, 13.9.2010. Bowling A. Research methods in health: investigating health and health services (2nd ed). Buchingham: Open University Press, 2002. Shaw CD, Kutryba B, Braithwaite J, Bedlicki M, Warunek A. Sustainable